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Dengue NS-1 Antigen (Rapid)

Bacterial/ Viral
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No Fasting Required

Details

Test for detecting dengue virus (NS1 antigen or IgM antibodies) in suspected dengue fever cases.

₹249₹300

17% OFF

Dengue NS-1 Antigen (Rapid) - Comprehensive Medical Test Guide

  • Why is it done?
    • Rapid detection of dengue virus infection through identification of NS-1 (Non-Structural Protein-1) antigen in blood serum, enabling early diagnosis during the acute phase of illness
    • Primary indications: patients presenting with fever, headache, muscle and joint pain, rash, and other symptoms suggestive of dengue infection, particularly during dengue epidemic periods in endemic regions
    • Used to differentiate dengue from other febrile illnesses such as malaria, typhoid, and other viral infections
    • Typical timing: performed within the first 3-5 days of fever onset when NS-1 antigen levels are highest in the bloodstream (acute/viremic phase)
    • Advantageous over IgM antibody detection as NS-1 antigen appears earlier in infection and persists for approximately 5-7 days from symptom onset
    • Enables rapid patient triage, treatment initiation, and epidemiological surveillance in clinical settings
  • Normal Range
    • Result Interpretation:
    • NEGATIVE: No dengue NS-1 antigen detected in the sample; indicates either absence of dengue infection or testing performed outside the window period when antigen is detectable (typically after 7 days of symptom onset)
    • POSITIVE: Dengue NS-1 antigen detected; indicates acute dengue virus infection during the viremic phase; positive result is diagnostic of dengue when patient presents with compatible clinical symptoms
    • Units: Qualitative result (Positive/Negative); some assays may report semi-quantitative values (Weak Positive, Moderate Positive, Strong Positive) based on antigen concentration
    • Sensitivity: Approximately 80-95% (varies by assay and dengue serotype); highest sensitivity in primary dengue infections
    • Specificity: Greater than 95% for dengue detection; low false-positive rate when performed correctly
  • Interpretation
    • Positive Result Interpretation:
    • Confirms acute dengue virus infection in symptomatic patients; clinician should initiate appropriate dengue management protocol including patient monitoring, symptomatic treatment, and surveillance for hemorrhagic complications
    • Indicates current viral replication and active viremia; patient is contagious and poses risk for mosquito transmission to others
    • Does not distinguish between dengue serotypes (DENV-1, DENV-2, DENV-3, DENV-4); serotype identification requires RT-PCR or additional molecular testing if clinically necessary
    • Negative Result Interpretation:
    • Does not exclude dengue if tested early (before day 1-2 of symptoms) or late (after day 7) when NS-1 antigen levels are below detection threshold; repeat testing or alternative diagnostic methods (IgM, RT-PCR) may be warranted
    • If negative with high clinical suspicion, consider other febrile illnesses (malaria, typhoid, chikungunya, Zika) and pursue appropriate alternative diagnostic workup
    • Factors Affecting Results:
    • Timing of specimen collection: critical variable; optimal detection occurs 1-5 days after fever onset; testing outside this window reduces sensitivity
    • Dengue serotype: primary infections (especially DENV-1) show higher NS-1 antigen levels; secondary infections may have lower antigen concentrations due to rapid antibody formation
    • Patient's immune status: immunocompromised individuals may have different antigen levels and prolonged viremia
    • Sample quality: hemolyzed or contaminated samples may produce false results; proper collection and handling essential
    • Test kit characteristics: different rapid test kits have varying sensitivities and specificities; manufacturer's instructions critical for accurate interpretation
  • Associated Organs
    • Primary Organ Systems Affected:
    • Cardiovascular system: dengue virus directly infects endothelial cells causing increased vascular permeability, thrombocytopenia, and potential hemorrhagic manifestations
    • Hematologic system: bone marrow affected with platelet count suppression, leukopenia during acute phase, and potential for disseminated intravascular coagulation in severe cases
    • Hepatic system: dengue causes hepatitis with elevated liver enzymes; can progress to acute liver failure in severe dengue hemorrhagic fever
    • Central nervous system: dengue encephalitis, meningitis, and Guillain-Barré syndrome reported in some cases; dengue virus can cross blood-brain barrier
    • Renal system: acute kidney injury can occur with severe dengue; direct viral infection and immune-mediated glomerulonephritis documented
    • Associated Medical Conditions:
    • Dengue Fever (DF): classic form characterized by fever, myalgia, arthralgia, headache, rash, lasting 5-7 days with gradual recovery
    • Dengue Hemorrhagic Fever (DHF): severe form with plasma leakage, hemorrhagic manifestations, thrombocytopenia, coagulopathy; can progress to dengue shock syndrome
    • Dengue Shock Syndrome (DSS): characterized by hypotension, shock, multi-organ failure; life-threatening complication with mortality rate 2.5-5% if untreated
    • Dengue-associated hepatitis: elevated transaminases (ALT/AST) and liver inflammation; usually resolves without sequelae
    • Dengue with neurological complications: meningitis, encephalitis, acute disseminated encephalomyelitis, transverse myelitis
    • Post-dengue syndrome: chronic fatigue, myalgia, arthralgia, mood disturbances persisting weeks to months after acute infection
    • Potential Complications with Abnormal Results:
    • Progressive plasma leakage during critical phase (days 3-7) causing ascites, pleural effusion, and hypovolemic shock if untreated
    • Hemorrhagic complications: spontaneous bleeding from mucous membranes, petechiae, ecchymoses, gastrointestinal bleeding; platelet count correlation with bleeding risk
    • Secondary bacterial infection: dengue immunosuppression increases susceptibility to bacterial superinfection
    • Multi-organ dysfunction: acute kidney injury, acute liver failure, myocarditis, and respiratory distress syndrome in severe cases
    • Maternal-fetal complications: vertical transmission in pregnant women causing fetal complications and neonatal dengue in third trimester infections
  • Follow-up Tests
    • Confirmatory and Complementary Tests:
    • RT-PCR (Reverse Transcription Polymerase Chain Reaction): gold standard for dengue detection; confirms NS-1 rapid test results and identifies specific dengue serotypes (DENV-1, DENV-2, DENV-3, DENV-4); particularly useful for negative rapid tests with high clinical suspicion
    • Dengue-specific IgM antibody test: performed if NS-1 negative but clinical suspicion remains high; positive after 3-5 days of symptom onset; indicates recent/acute infection
    • Dengue-specific IgG antibody test: appears after 7-14 days; indicates past infection or immunity; useful for epidemiological studies and secondary infection identification
    • Hematologic Monitoring Tests:
    • Complete Blood Count (CBC): essential for monitoring platelet count, hemoglobin, white blood cell count; repeated every 24-48 hours in hospitalized patients to assess disease progression and hemorrhagic risk
    • Coagulation studies (PT, INR, aPTT): performed in patients with hemorrhagic manifestations or platelet count <50,000/μL to assess coagulopathy severity
    • Biochemical and Liver Function Tests:
    • Liver Function Tests (ALT, AST, bilirubin, albumin): assess hepatic involvement; typically elevated in dengue; repeated as needed to monitor for acute liver failure
    • Renal function tests (creatinine, BUN, electrolytes): evaluate for dengue-associated renal involvement; baseline and follow-up testing for severe cases
    • Blood glucose monitoring: dengue can cause hypoglycemia; regular monitoring especially in severe infections and pediatric patients
    • Imaging Studies:
    • Abdominal ultrasound: performed in patients with warning signs (persistent vomiting, plasma leakage signs, abdominal pain) to detect ascites, pleural effusion, gallbladder wall thickening suggestive of plasma leakage
    • Chest X-ray: for evaluation of respiratory symptoms, pleural effusion, or suspected acute respiratory distress syndrome
    • Monitoring Frequency and Duration:
    • Ambulatory patients: clinical reassessment every 24-48 hours during fever phase; additional laboratory tests based on warning signs development
    • Hospitalized patients: daily CBC and liver function tests minimum; more frequent monitoring (every 12 hours) for critically ill patients with hemorrhagic features
    • Convalescent phase monitoring: post-dengue syndrome assessment at 2-4 weeks if symptoms persist; neurological follow-up if CNS involvement documented
    • Differential Diagnosis Testing:
    • Malaria blood smear/Rapid diagnostic test: if dengue negative and malaria endemic; concurrent malaria-dengue infection possible in some regions
    • Typhoid serology/Blood culture: for fever of unknown origin or negative dengue with high suspicion for bacterial infection
    • Chikungunya/Zika virus serology: consider in endemic regions with similar clinical presentations
  • Fasting Required?
    • Fasting: NO - Fasting is NOT required for the Dengue NS-1 Antigen (Rapid) test; blood specimen can be collected at any time of day regardless of meal intake
    • Sample Collection Requirements:
    • Venous blood sample: typically 2-5 mL collected in SST (Serum Separator Tube) or plain vacutainer tube for serum preparation; some rapid test kits accept capillary blood from finger stick if venipuncture not available
    • Sample handling: allow blood to clot at room temperature for 15-30 minutes; centrifuge to obtain serum; do not use hemolyzed or lipemic serum as it may compromise test accuracy
    • Storage: serum specimens stable at room temperature for several hours; for delayed testing, refrigerate at 2-8°C for up to 48-72 hours; prolonged storage may require freezing at -20°C
    • Patient Preparation Instructions:
    • No specific dietary restrictions: patient may eat and drink normally before specimen collection
    • Hydration: patient should maintain normal hydration status for optimal venipuncture and specimen quality
    • No medications to avoid: routine medications do not interfere with dengue NS-1 antigen detection; however, anticoagulants (warfarin, heparin) should be noted if patient on blood thinners
    • Specimen timing: optimal collection during first 1-5 days after fever onset for maximum test sensitivity; inform patient of importance of early testing
    • Special Considerations:
    • Infectious disease safety: dengue-positive specimens handled as biohazardous material; laboratory personnel follow standard precautions and biosafety level 2 practices
    • Pediatric patients: same collection requirements apply; capillary collection from heel stick acceptable in infants if needed
    • Specimen labeling: ensure proper patient identification and collection time documentation for result interpretation and medical record documentation

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